Review appointment checklist

Here is a checklist on topics to cover at a patients' review appointment:

• is the patient's diet gluten-freeWhen a food has less than 20 parts per million (ppm) of gluten so it is safe for people with coeliac disease to eat. ?
• are their symptoms resolved?
• if symptoms are unresolved it could be due to contamination/oats/barley malt extractIs widely used in a food as a flavour enhancer. It depends on the quantity used as to whether or not people with coeliac disease can eat food that contains it. /Codex wheat starchA specially manufactured kind of wheat starch that has been washed to reduce the level of gluten to a trace level within the Codex standard. /lactose intoleranceWhen the body has a reaction to certain kinds of milk.
• is the patient receiving food on prescription? 
• if antibody levels are available, have these improved since diagnosis - note that levels tend to drop steeply initially but may not become negative for several months
• iron levels - is the patient anaemic? If so, are levels increasing and are supplements required?
• is the patient achieving a good calcium intake? If not, is there a need for calcium supplements?
• has a DEXA scan been carried out? If not, check the patient has been referred for one. If results are available tailor dietary advice as necessary
• has the patient joined Coeliac UK? Are they updating their Food and Drink DirectoryOur annual Directory of gluten-free food and drink which manufacturers voluntarily submit to. on a monthly basis?
• does the patient have a good understanding of allergenSomething which causes an allergic reaction. labelling?
• weight and BMI - is the patient's weight stable/decreasing/increasing and is the BMI within the healthy range?